| Theme | Clinical Diagnosis and Management of Gastric Cancer 2019 -- Current Status and Issues | |
|---|---|---|
| Title | Advances in the Treatment for Gastric Cancer in Advanced Stage: New Evidences Relevant to Open Surgery | |
| Publish Date | 2019/10 | |
| Author | Itaru Yasufuku | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| Author | Kazuhiro Yoshida | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| Author | Kazuya Yamaguchi | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| Author | Toshiyuki Tanahashi | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| Author | Takeharu Imai | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| Author | Tomonari Suetsugu | Department of Surgical Oncology, Gifu University Graduate School of Medicine |
| [ Summary ] | Japanese Gastric Cancer Treatment Guidelines 5th edition was published recently and new evidence to support open surgery for advanced stage gastric cancer was established. A Phase III clinical trial showed non‒inferiority of spleen preserving total gastrectomy for gastric cancer located in upper third of the stomach which did not invade greater curvature over total gastrectomy with splenectomy. Splenectomy merely caused postoperative complications. Another phase III clinical trial indicated that palliative gastrectomy did not offer survival benefits for gastric cancer patients with non‒curable Stage IV factor. Palliative gastrectomy was likely to increase adverse events in chemotherapy patients and decrease patients' tolerance of chemotherapy. Though the standard treatment for advanced gastric cancer is chemotherapy, several recent reports have shown excellent long term outcomes using conversion therapy. Conversion therapy was defined as a surgical treatment aiming at an R0 resection after chemotherapy for tumors that were originally unresectable or marginally resectable for technical and/or oncological reasons. Conversion therapy may offer survival benefits including even a cure for Stage IV gastric cancer patients. |
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